Cat’s out of the bag
Over the last month I have shared my struggles of going through mental health, and during this time I have learned a lot — some good and some straight out appalling. Today I received a call from Doctor E. This doctor had spent some time reading The Ranger and found my articles sad and disturbing. Doctor E. invited me to his office to discuss my situation. When I have been called by a ranking official in the past, it has always been by a person who is recommending that I stop writing or, better yet, someone threatening me with some sort of punishment. I believe whole heartedly that men who have put their lives on the line undoubtedly have the right to speak their minds, but of course, in a professional, educated manner, making sure that when you open your mouth your foot won’t be inserted a short time later. You also must make sure you’re above reproach and know that what you say is open to everyone in the world, and that means your words can be used against you at anytime. Writing on such a thin line is difficult, but to know that when I open my e-mails there are people who are being touched and finding courage to face the things that I have encountered over time in the service, it is worth every ounce of punishment that comes my way.
In this meeting I had a chance to share my experiences while going through the mental health program. As usual, my wife came along. As I have said before, she is like the alarm clock for when I am going to have an episode. I really wanted her to be there because my wife is fed up with how things are going, and she is ready to join the fight. I basically let the cat out of the bag about everything that had happened and what was going on with others making their way through the system. Doctor E. didn’t shake his head or write down notes. He listened, and he treated me like a man and showed complete respect for my position. I will say, however, that at first I thought his asking me to come in would give him a chance to convince me in a nice way to stop talking about the system’s failure to give proper treatment. The doctor gave me the story on how he went about getting me to come in. The only thing in the story that really struck a chord with me, as well as with my wife, was all the people he contacted just to get me there. The one thing that threw up red flags was that he had sent my articles about the system to Public Affairs. I sidelined the thought that this man was trying to get me shutdown and let the meeting take place. In time I will ask him what his intent was by doing that. The one thing I have learned from writing in the paper is that if what you’re writing about could cause an uproar or open the gates to investigation people will go to any length — even being nice — to shut you up. I honestly think Doctor E.’s intentions are good, and I believe he will do the right thing and get me where I am supposed to be. But honestly, how many times have I written that same line? I almost feel like a liar when I write that. Now that is sad.
The meeting ended but not without a grand finale. The next part I write will shock some of you, and others will just say go figure. During the meeting, the conversation came up about my experience at the place where I last was receiving treatment. While trying to receive treatment, I was given an early diagnosis by an individual my wife and I refer to as Doctor Evil. From this place I was given a referral to the University of Washington to get treatment from one of the best psychologists in the country, Dr. Marsha M. Linehan. Doctor E. was really glad that I was going to see her, but then while I was in mid-sentence, he asked the question of the day. “Do you know why you are going there?” I looked at him and then looked at my wife and said, “Well, I have this temporal lobe issue going on.” The doctor had a look on his face as if he had something to tell me but I had to say the magic words to get the answer. After telling Doctor E. in not so many words “No, I don’t know why I am going there,” he said, “I know why you’re going there.” I laughed. “At least someone knows something.” He went to get the referral paper. He wasn’t gone long, but something started to make me think something wasn’t right. I wasn’t sure what it was, but I knew something was coming, and oh boy, it did. He walked in the room with a paper in his hand. It was like on a television show when the doctor comes in with important information — key the music. He put the paper in front me, and there it was in bold print — words that practically paralyzed my thought process. It was written by Doctor Evil, the one who had told me that in his professional opinion it was looking like temporal lobe seizures. Like a good little investigator, I researched the topic, and sure enough, Doctor Evil was on it. All of the symptoms matched, and for once I was getting to know what was going on with me upstairs. On the referral paper was written: “Patient needs care at the University of Washington, Dept. of psychology Dr. Linehan for treatment of his personality disorder.”
On the line below the provisional diagnosis, which is basically an interim statement of what he thinks I have, it read in uppercase letters as if it was slapping me in the face: ADJUSTMENT DISORDER WITH DISTURBANCE OF EMOTIONS AND CONDUCT.
In my mind, this is where the meeting ended and where the nice, gentle, and compassionate Dave needed to start flexing his disapproval of this lame, loose diagnosis. But before I could get into my business mode, Doctor E. quickly gave me insight. He completely disagreed with this diagnosis. Granted, he did admit that he didn’t have all of my information, but he knew this loose diagnosis was off. And he wanted to make sure this was rectified. After some time, he explained what he was going to do. Basically, he wanted me to give his people a chance to give me treatment. If you have followed me for the past few months, you know I have been through just about every possible treatment that a person can undergo, and no one has been able to handle me. If I am not in the right place with people who understand what is going on when I have one of these episodes, people will most likely pick up the phone and call the police — like the last place where I received treatment. They were not ready even though I had given them plenty of warnings. They ended up calling the police. Later they completely denied they had done so, but I saw the lady dialing the phone. Anyway, that’s over, and I have moved on.
But let’s go back to Doctor Evil’s loose diagnosis. By the way, my mother and father got a kick out of this. At the same time, both are enraged at this and feel like the system has failed me, and they feel hopeless in the matter as well. I took some time to do some research on this personality disorder and some of the history that goes behind it with men in the service. What I found floored me, and I couldn’t even talk to my wife for an hour. This is what I uncovered. I also talked to men and women who were kicked out of the service for this. Their stories have brought enlightening information to the forefront.
Understanding this loose diagnosis and the criteria, if you know me you will laugh so hard you might cry. I did. The information below comes from the American Psychiatric Association (aka APA).
General diagnostic criteria
Diagnosis of a personality disorder must satisfy the following general criteria in addition to the specific criteria listed under the specific personality disorder under consideration.
A. Experience and behavior that deviates markedly from the expectations of the individual's culture. This pattern is manifested in two (or more) of the following areas:
1. cognition (perception and interpretation of self, others and events)
2. affect (the range, intensity, liability, and appropriateness of emotional response)
3. interpersonal functioning
4. impulse control
B. The enduring pattern is inflexible and pervasive across a broad range of personal and social situations.
C. The enduring pattern leads to clinically significant distress or impairment in social, occupational, or other important areas of functioning.
D. The pattern is stable and of long duration and its onset can be traced back at least to adolescence or early adulthood.
E. The enduring pattern is not better accounted for as a manifestation or consequence of another mental disorder.
F. The enduring pattern is not due to the direct physiological effects of a substance or a general medical condition such as head injury.
I am not a doctor, but what I am seeing is completely not matching up with the things that have occurred and the things I have experienced. I am going to put my faith in the new direction my treatment is going and hope someone takes more time listening to me rather than just loosely diagnosing me.
Like a professional reporter, I sought those who have been thrown out of the military because of this issue. I am always picky about who I interview and make sure the stories are right.
The following information is revealing.
I talked to a highly educated military paralegal. We sat down and had a great lunch. What I learned follows. Due to the content of his statements, I will keep his name private to save him the pain of retribution.
Question #1: So what is a 5-13, and how many young men are being discharged from the military due to this? And what does it really mean?
The paralegal replied: “Regulation 635-200, Administrative Separations is what covers this issue, specifically Chapter 5, sub-paragraph 13 of AR 635-200. This section is titled ‘Separation because of personality disorder.’ In short, this means that you are being separated because a qualified mental health professional has diagnosed you with a pre-existing mental condition.”
Question #2: What does this mean to a solider?
Paralegal: To be honest, there are some service members that have this issue and there are men with PTSD. Basically 5-13 is failure to adjust. In reality, when you hear of a soldier getting the boot it is under this clause; in reality, there is no real failure to adapt section.
Question #3: What is experience with command and psychiatrist in your professional opinion?
Paralegal: Usually, in my experiences, the psychiatrist that is working with the soldier communicates with the service member’s command. To not make this process rather complicated, if by chance the commander just desires to get rid of the service member it is a good chance they will diagnose the service member rather fast. The good thing in this whole operation is there is really no harm because 5-13, unless there is other documented misconduct, carries with it an Honorable Discharge.
Question #4: So if they diagnose me with personality disorder knowing that the service member has been to combat and has been involved in a combat related injury, how does that work?
Paralegal: This is a very tricky question, and many men I have talked to feel betrayed by the mental health professional because of it. But because the lack of education or sometimes advocacy, these men go through the process and say and do nothing. If you are chaptered out with this 5-13, don’t think the VA or military is going to be cutting you a check for disability; that won’t happen.
Question #5: What would be your advice for those who feel like they are getting the raw deal from the military and the VA?
Paralegal: Since you’re not using my name and you are a dear friend of mine, Dave, I would tell a service member to really look at this process in two ways. The VA is a good place but backed up. Over 22,000 service members, (according) to what records say, have been discharged with issues since the war started, but I think the number is way higher. Some service members legitimate, some not so. The system is packed, and waiting could take forever. I recommend to get some action that speaks volumes. As you say, Dave, a lot when we talk: Go talk to the men and women in the black suits or dress suits. Basically, contact your elected officials, and from there heads will start rolling, because no one wants to be under the microscope, and as you know it already is. You will be amazed what happens when an issue like this hits the big papers. I will say I have seen success stories; there are few, but there are some.
Questions #6: I have known you for some time, and I have never really talked shop with you about subjects like this, but I believe you are a man who does his job and has conviction. This my last question. How many times do you think people in your profession see these things come across their case files and want to do something, but since speaking up and taking action sometimes results in consequences, the paralegal just does what he is trained to do?
Paralegal: Complacency is a sin many of us deals with, but often or not, the men and women I work with will fight to do what’s right. And that is why I wholeheartedly believe in this system. Dave, my last recommendation is don’t let someone say that when you were a boy your life was a mess and because of that you are the way you are. I know you, and many thousands of others know you. Fight it. I know in due time things will get better.
I learned a lot from my friend and have gained knowledge that will lead me through the next phases of this hell-like roller coaster. There will be a good ending, because I won’t accept anything less. You know, I didn’t grow up in the “Brady Bunch” household even though I was told I did by many of my friends. Still, my family life was great, and to this day my parents are role models for me. Not once have I ever been asked about my childhood, only how I did in school. The good news in all of this is my case manger has gone out and started knocking down doors and getting things done — even while she is on leave. Why can’t everyone be like this woman?
The update as I write this is the principal doctors are going to have a telephone conference and start working jointly to get things going in the right direction. I have been told that they will get that diagnosis off my record and put the right one on there. Hours ago I sat on my porch thinking to myself: “I can’t believe that I have served my country, doing my tours, get blown up, and receive a Purple Heart. I am a soldier who for almost four years has not had more than one negative counseling packet — no breaking the law, always trying to be a good, moral person. This is what I get? Some doctor wants to say, ‘Nope, you’ve been this way all along.’”
What this doctor didn’t realize is that all of these years I have fought this thing tooth and nail and while fighting this monster I have slightly lost who I am. When that explosion occurred on that hot, humid April in Iraq, I knew immediately something had changed. I wasn’t the only causality of that night. Many miles away in the good United States this issue would be affecting everyone around me. To this day, my rock is my wife and the fort I have made at home, where I find safety. I know who I am and who I was, and only God knows what is in store for me and who I will be on this road. I believe God has brought me to this point for something, and if it is just to raise hell and get health professionals to wake up and start treating every single warrior like he deserves, then I accept this mission. The next few weeks should be a good ride. Again, thanks to everyone for your support and another thank-you to my paralegal friend. (Final note: Just in case there is a search party for him, you won’t find my paralegal friend on post. You don’t think I would be that silly, do you?)